Antipsychotic-induced weight gain is a major concern in the treatment of psychosis. The efficacy of non-pharmacological interventions as well as the optimal intervention approach for this side-effect remain unclear.

To determine the effectiveness of non-pharmacological interventions and specific treatment approaches to control antipsychotic-induced weight gain in patients with firstepisode or chronic schizophrenia.

Systematic review and meta-analysis of randomised controlled trials.

Ten trials were included in the meta-analysis. Adjunctive non-pharmacological interventions, either individual or group interventions, or cognitive-behavioural therapy as well as nutritional counselling were effective in reducing or attenuating antipsychotic-induced weight gain compared with treatment as usual, with treatment effects maintained over follow-up.

Non-pharmacological weight-management interventions should be a priority, particularly during the early stages of antipsychotic treatment. Preventive approaches have the potential to be more effective, acceptable, cost-efficient and beneficial.

The long-term effect of anxiety and depression on blood pressure is unclear.

To examine the prospective association of anxiety and depression with change in blood pressure in a general population.

Data on 36530 men and women aged 20–78 years participating in the Nord-Tr⊘ndelag Health Study (HUNT) in Norway in 1984–86 were re-examined 11 years later.

A high symptom level of anxiety and depression at baseline predicted low systolic blood pressure (< 10th percentile) at follow-up (OR=1.30, 95% CI 1.08–1.57) when those with low systolic blood pressure at baseline were excluded. Change in symptom level of anxiety and depression between baseline and follow-up was inversely associated with change in systolic blood pressure. For diastolic blood pressure, the findings were weaker or non-significant.

Symptoms of anxiety and depression predicted lower blood pressure 11 years later.

Unemployment is a major problem for people with first-episode psychosis and schizophrenia. This has repercussions for the economy, social functioning and illness prognosis.

To examine whether a vocational intervention - individual placement and support (IPS) - which has been found to be beneficial in populations with chronic schizophrenia, was a useful intervention for those with first-episode psychosis.

A total of 41 people with first-episode psychosis were randomised to receive either 6 months of IPS + treatment as usual (TAU) (n=20) or TAU alone (n=21).

The IPS group had significantly better outcomes on level of employment (13 v. 2, P<0.001), hours worked per week (median 38 v. 22.5, P=0.006), jobs acquired (23 v. 3) and longevity of employment (median 5 weeks v. 0, P=0.021). The IPS group also significantly reduced their reliance on welfare benefits.

Individual placement and support has good potential to address the problem of vocational outcome in people with first-episode psychosis. This has economic, social and health implications.

The Taql-A polymorphism of the ANKK1 gene, adjacent to the DRD2 gene, has been associated with alcoholism and other psychiatric conditions, although other DRD2 gene variants, such as the C957T polymorphism, could be related to these phenotypic traits.

To investigate the contribution of the Taql-A and the C957T polymorphisms to the presence of psychopathic traits in patients with alcoholism.

We performed association and interaction analyses of the polymorphisms in 150 controls and 176 male alcohol-dependent patients assessed for the presence of dissocial personal disorder, using the Psychopathy Checklist-Revised (PCL-R).

There was a significant association of the Taql-A and C957T polymorphisms when both genotypes were present, with PCL-R scores of F1–171=0.13 (P=0.01) and a frequency of dissocial personal disorder OR=10.52, P<0.001.

The Taql-A of the ANKK1 gene and the C957T of the DRD2 gene are epistatically associated with psychopathic traits in alcohol-dependent patients.

Convergent evidence implicates white matter abnormalities in bipolar disorder. The cingulum is an important candidate structure for study in bipolar disorder as it provides substantial white matter connections within the corticolimbic neural system that subserves emotional regulation involved in the disorder.

To test the hypothesis that bipolar disorder is associated with abnormal white matter integrity in the cingulum.

Fractional anisotropy in the anterior and posterior cingulum was compared between 42 participants with bipolar disorder and 42 healthy participants using diffusion tensor imaging.

Fractional anisotropy was significantly decreased in the anterior cingulum in the bipolar disorder group compared with the healthy group (P=0.003); however, fractional anisotropy in the posterior cingulum did not differ significantly between groups.

Our findings demonstrate abnormalities in the structural integrity of the anterior cingulum in bipolar disorder. They extend evidence that supports involvement of the neural system comprising the anterior cingulate cortex and its corticolimbic gray matter connection sites in bipolar disorder to implicate abnormalities in the white matter connections within the system provided by the cingulum.

It has been stated that rates of homicide due to mental disorder are constant over time.

To examine whether there were changes in the rates of homicide due to mental disorder over time, and whether changes in these rates were associated with changes in the rates of other homicides in England and Wales.

Examination of four sets of official homicide statistics from England and Wales from 1946 to 2004.

The rate of total homicide and the rate of homicide due to mental disorder rose steadily until the mid-1970s. From then there was a reversal in the rate of homicides attributed to mental disorder, which declined to historically low levels, while other homicides continued to rise.

The reasons for the rise and fall in homicides attributed to mental disorder are not clear. The earlier increase in such homicides may have been due to the same sociological factors that caused the increase in other homicides over that time. The subsequent decline may have been due to improvements in psychiatric treatments and service organisation. Another possibility is that there has been an informal change to the legal tests for the finding of homicide due to mental disorder.

Although childhood abuse is an important correlate of suicidality, not all individuals who were abused as children attempt suicide.

To identify correlates and moderators of suicide attempts in adults reporting childhood physical abuse, contact sexual abuse, or both.

A French-Canadian, school-based cohort (n=1684) was prospectively followed.

The identity of the abuser moderated the relationship of abuse frequency and suicide attempts, with individuals abused by their immediate family being at highest risk. Although paternal education exhibited negative associations (OR=0.71, 95% CI 0.58–0.88), several externalising phenotypes had positive associations with suicide attempts: disruptive disorders (OR=3.10, 95% CI 1.05–9.15), conduct problems (OR=1.09, 95% CI 1.01–1.19) and childhood aggression (OR=1.41, 95% CI 1.08–1.83).

Characteristics of the abuser and abusive acts may be important additional indicators of risk for suicide attempts. Future research needs to employ developmental approaches to examine the extent and mechanisms by which childhood abuse contributes to the shared variance of suicidality, maladaptive traits and psychopathology.

Parents' perspectives on self-harm are considered important, but have not been explored.

To gain perspective of parents of adolescents who self-harm on: (a) history of self-harm and health service provision; (b) their understanding and ability to make sense of self-harm behaviour; (c) emotional and personal impact; and (d) parent skills as carer and hope for the future.

Interpretative phenomenological analysis was applied to semi-structured interviews with 12 parents of adolescents receiving treatment for self-harm in community child and adolescent mental health services.

Parents commonly suspected and spotted self-harm prior to disclosure or service contact; however, communication difficulties and underestimating significance led to delays in addressing the behaviour. Parents struggled to understand and cope with self-harm.

Parents require advice and support from outside services to help them manage self-harming behaviour and its personal impact. This study suggests parents are early to spot signs of self-harm, indicating their key role in reaching young people in the community who remain unknown to health services.

Some studies have shown the presence of psychopathological disorders in transient global amnesia.

To determine whether transient global amnesia is associated with psychopathological disorders and to assess the influence of these psychopathological disorders on memory impairments.

Levels of anxiety and depression before and during transient global amnesia were rated. Memory performances were assessed by means of original episodic memory tasks and working memory tasks. These data were collected in 17 individuals observed during the very acute phase, 18 individuals examined in the peri-acute phase and 26 controls.

During the acute phase, participants with transient global amnesia displayed a higher level of anxiety and a more depressed mood than controls. An alteration of emotional state, as measured by the Adjective Mood Scale, was correlated with deficits in anterograde memory.

Transient global amnesia comprises sudden changes in people's emotional state, which has a major impact on and interacts with episodic memory impairment.

Magnetic seizure therapy, in which seizures are elicited with a high-frequency magnetic field, is under development as a new treatment for major depressive disorder. Its use may be justified if it produces the antidepressant effects of electroconvulsive therapy (ECT), coupled with limited cognitive side-effects.

To evaluate the usefulness of a new 100 Hz magnetic seizure therapy device.

We induced seizures with 100 Hz magnetic transcranial stimulation in 11 patients with major depressive disorder during one session of a regular course of ECT. Recovery times after seizures induced by magnetic seizure therapy and ECT were compared.

Seizures could be elicited in 10 of the 11 patients. Stimulation over the vertex produced tonic-clonic activity on 9 out of 11 occasions. Stimulation over the prefrontal midpoint elicited seizures on 3 out of 7 occasions. The mean duration of magnetically induced seizures was 31.3s, ranging from 10 to 86s. All patients had an exceptionally quick recovery of orientation: mean of 7 min 12s (s.d.=2 min 7 s, range 4 min 20s to 9 min 41 s). The recovery times were on average 15 min 35s shorter with magnetic seizure therapy than with ECT in the same patients (paired-samples t-test: P<0.0001). Patients reported feeling less confused after magnetic seizure therapy. Side-effects were confined to myoclonic movements, associated with the use of etomidate.

The new 100Hz magnetic stimulator elicits seizures in the majority of patients when administered over the vertex. Magnetic seizure therapy was associated with shorter recovery times and less confusion following treatment. Subsequent work will be required to assess the safety and effectiveness of magnetic seizure therapy in the treatment of depression.

Expert clinical judgement combines technical proficiency with humanistic qualities.

To test the psychometric properties of questionnaires to assess the humanistic qualities of working with colleagues and relating to patients using multisource feedback.

Analysis of self-ratings by 347 consultant psychiatrists and ratings by 4422 colleagues and 6657 patients.

Mean effectiveness as rated by self, colleagues and patients, was 4.6, 5.0 and 5.2 respectively (where 1=very low and 6=excellent). The instruments are internally consistent (Cronbach's alpha > 0.95). Principal components analysis of the colleague questionnaire yielded seven factors that explain 70.2% of the variance and accord with the domain structure. Colleague and patient ratings correlate with one another (r=0.39, P<0.001) but not with the self-rating. Ratings from 13 colleagues and 25 patients are required to achieve a generalisability coefficient (Eρ2) of 0.75.

Reliable 360-degree assessment of humane judgement is feasible for psychiatrists who work in large multiprofessional teams and who have large case-loads.